A 38-year-old male presented with moyamoya disease. Occlusion of the bilateral proximal posterior cerebral arteries (PCAs) resulted in homonymous 3/4 (right half and left lower quadrant) anopsia and various mental symptoms. To prevent impending cortical blindness, revascularization to the right PCA was performed by occipital artery (OA) to calcarine artery anastomosis. His neurological state was stabilized. OA-cortical PCA (calcarine artery) anastomosis is an alternative to omentum transplantation or occipital burr hole procedures for impending cortical blindness.